血清长链非编码RNA核仁小RNA宿主基因8与微小RNA-21水平在高危型人乳头瘤病毒阳性患者中的表达及对宫颈癌的诊断价值

The expression changes of lncRNA SNHG8 and miR-21 levels in high-risk HPV positive patients and their diagnosis for cervical cancer

目的探析血清长链非编码RNA核仁小RNA宿主基因8(lncRNA SNHG8)、微小RNA-21(miR-21)在高危型人乳头瘤病毒(HPV)阳性患者对宫颈癌的诊断价值及经扶正清毒颗粒治疗后的表达变化。方法回顾性分析2021年1月至2022年11月枣庄市妇幼保健院收治的160例高危型HPV阳性患者病历资料,收集患者临床资料,采用实时荧光定量聚合酶链式反应(RT-qPCR)检测血清lncRNA SNHG8、miR-21表达水平。所有患者均接受扶正清毒颗粒治疗,停药6月后随访,根据预后结局分为宫颈癌组(34例)、非宫颈癌组(126例)。对比高危型HPV阳性患者治疗前后血清lncRNA SNHG8、miR-21水平和不同预后结局高危型HPV阳性患者临床特征;多因素logistic分析高危型HPV阳性患者治疗后发生宫颈癌的独立影响因素;采用受试者工作特征(ROC)曲线分析血清lncRNA SNHG8、miR-21对高危型HPV阳性患者发生宫颈癌的预测价值。结果治疗后高危型HPV阳性患者血清lncRNA SNHG8、miR-21水平均低于治疗前(P<0.05)。对比不同预后结局患者高危型HPV阳性患者的绝经情况、分娩史、HPV分型资料,差异无统计学意义(P>0.05);而年龄、血清lncRNA SNHG8、miR-21表达,差异有统计学意义(P<0.05)。logistic回归分析结果显示年龄、血清lncRNA SNHG8、miR-21均为高危型HPV阳性患者治疗后发生宫颈癌的独立危险因素(P<0.05)。ROC曲线结果显示,血清lncRNA SNHG8、miR-21联合预测高危型HPV阳性患者发生宫颈癌的曲线下面积为0.847,高于单一生物标志物(lncRNA SNHG8、miR-21),P<0.05,其灵敏度、特异度分别为83.52%、86.41%。结论血清lncRNA SNHG8、miR-21为高危型HPV阳性患者宫颈癌独立影响因素,可用于高危型HPV阳性患者疗效及宫颈癌发病风险的评估,且联合应用效能更高。

Objective To explore the expression changes of long non coding RNA small nucleolar RNA host gene 8(lncRNA SNHG8)and microRNA-21(miR-21)in high-risk human papillomavirus(HPV)positive patients after treatment with Fuzheng Qingdu granules,and their diagnostic value for cervical cancer.Methods The medical records of 160 high-risk HPV positive patients admitted to Zaozhuang Maternal and Child Health Hospital from January 2021 to November 2022 were analyzed retrospectively.Clinical data of the patients were collected,and real-time fluorescence quantitative polymerase chain reaction(RT-qPCR)was used to detect the expression levels of serum lncRNA SNHG8 and miR-21.All patients received treatment with Fuzheng Qingdu Granules,and were followed up for 6 months after the drug discontinuation.According to the prognosis,they were divided into cervical cancer group(n=34)and non cervical cancer group(n=126).The serum lncRNA SNHG8 and miR-21 levels of high-risk HPV positive patients compared before and after treatment;Compare the clinical characteristics of high-risk HPV positive patients with different prognostic outcomes.Multivariate logistic analysis was used to detect independent influencing factors for the development of cervical cancer in high-risk HPV positive patients after treatment.The predictive value of serum lncRNA SNHG8 and miR-21 for the development of cervical cancer in high-risk HPV positive patients was analyzed using receiver operator characteristic curve(ROC)analysis.Results After treatment,the serum lncRNA SNHG8 and miR-21 levels in high-risk HPV positive patients were decreaed(P<0.05).There was no statistically significant difference(P>0.05)in the menopausal status,delivery history,and HPV typing data of high-risk HPV positive patients with different prognostic outcomes.The differences in age,serum lncRNA SNHG8,and miR-21 expression data were statistically significant(P<0.05).The logistic results showed that age,serum lncRNA SNHG8,and miR-21 were independent risk factors for cervical cancer in high-risk HPV positive patients after treatment(P<0.05).The ROC curve results showed that the combined prediction of serum lncRNA SNHG8 and miR-21 for high-risk HPV positive patients with cervical cancer had an area under curve(AUC)of 0.847,which was higher than that of single biomarkers(lncRNA SNHG8,miR-21),P<0.05.Its sensitivity and specificity are 83.52%and 86.41%,respectively.Conclusions Serum lncRNA SNHG8 and miR-21 are independent influencing factors for cervical cancer in high-risk HPV positive patients,and can be used for evaluating the therapeutic effect of high-risk HPV positive patients and the risk of cervical cancer.The combined application has higher diagnostic efficacy.